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目的:羟乙基淀粉(HES)对大耳兔腹部大手术术后早期肠系膜微血管清蛋白(ALB)渗漏的影响,为防止腹部大手术术后早期微血管ALB渗漏提供理论依据。方法:取大耳兔18只,随机分为对照组、等渗盐水组和HES组。对照组不给予任何干预,后两组均行胃大部切除加胰体尾、脾切除术,术后采用等热量和等氮量营养支持,等渗盐水组术后给予25 ml/(kg·d)等渗盐水,HES组术后给予6%HES(130,0.4)25 ml/(kg·d)。术前和术后48 h检测血清ALB浓度,三组兔术后48 h通过静脉注射异硫氰酸罗丹明B标记的牛血清ALB,在激光共聚焦显微镜下动态观察大耳兔肠系膜微血管ALB渗漏情况,并计算其微血管(ALB)渗透率。结果:三组大耳兔术前血清ALB浓度差异无统计学意义(P>0.05)。HES组大耳兔术后48 h血浆ALB浓度明显升高,与等渗盐水组比有显著性差异(P<0.05),微血管ALB渗漏明显降低(P<0.05)。结论:大耳兔腹部大手术术后早期存在低ALB血症,给予HES可减少早期微血管ALB渗漏,提高术后早期血浆ALB浓度。
OBJECTIVE: To investigate the effect of hydroxyethyl starch (HES) on the early leakage of mesenteric microalbumin (ALB) after major abdominal surgery in large eared rabbit, so as to provide a theoretical basis for prevention of early microvascular ALB leakage after major abdominal surgery. Methods: Eighteen rabbits were randomly divided into control group, isotonic saline group and HES group. In the control group, no intervention was given. The patients in the latter two groups were given gastrectomy and splenectomy. The patients were given equal calorie and equal nitrogen nutrition support. The rats in the isotonic saline group were given 25 ml / kg d) Isotonic saline, HES group was given 6% HES (130,0.4) 25 ml / (kg · d) after operation. Preoperative and postoperative 48 h serum ALB levels were detected 48 h after the operation by intravenous injection of rhodamine B isothiocyanate B labeled bovine serum ALB in the laser scanning confocal microscope dynamic observation of rabbit ears mesenteric microvascular ALB infiltration Leakage situation, and calculate its micro-vascular (ALB) permeability. Results: There was no significant difference in preoperative serum ALB levels among the three groups of rabbits (P> 0.05). The ALB concentration of HES group at 48 h after operation was significantly higher than that of isotonic saline group (P <0.05), and the ALB leakage of microvessels was significantly decreased (P <0.05). CONCLUSION: Hypoalbuminemia is present early after major surgery in large-eared rabbits. Pretreatment with HES can reduce the early microvascular leakage of ALB and increase the plasma ALB concentration in early postoperative period.